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When they were first built, before the negative connotations of shock therapy and trans-orbital lobotomies, mental asylums were a place of refuge. They were a place of safety. They were a society’s attempt at doing the right thing, providing a home and care for those who could do neither for themselves. Most of the grand asylums we think of today were built in the late 1800s. Work on the asylum in Weston began in Virginia and was completed in West Virginia, that should give you a clue to its age. Before the asylum system was created in America the mentally ill were typically placed in one of four categories. If they were connected to a family of wealth, they stayed in a hospital. If they had a very patient and capable family, they were cared for by loved ones. If neither of those were options, they ended up in jails or homeless on the streets. In the jails they were often separated in an outdoor cage or killed by other inmates. Their lives on the street were equally bitter and short.

Dorothea Dix, a god fearing, unmarried school-teacher, became aware of the circumstances of the mentally ill after a visit to a prison in her home state of Massachusetts. She was appalled by their conditions and quickly jumped to action. She travelled the state documenting their lives and lobbying for a place of refuge for the mentally ill. She spoke with congressmen and senators, fighting for the care of those who couldn’t care for themselves. She was immediately successful. An expansion of the prison in Worcester was built specifically for the mentally ill. Soon she travelled across the east coast, lobbying in each state on the way, all the while providing examples of the terrible conditions to leadership. Below is the first paragraph of Dorothea Dix’ plea to the General Assembly in North Carolina.


I admit that public peace and security are seriously endangered by the non-restraint of the maniacal insane. I consider it in the highest degree improper that they should be allowed to range the towns and country without care or guidance; but this does not justify the public in any State or community, under any circumstances or conditions, in committing the insane to prisons; in a majority of cases the rich may be, or are sent to Hospitals; the poor under the pressure of this calamity, have the same just claim upon the public treasury, as the rich have upon the private purse of their family as they have the need, so have they the right to share the benefits of Hospital treatment. Urgent cases at all times, demand, unusual and ready expenditures in every community… If County Jails must be resorted to for security against the dangerous propensities of madmen, let such use of prison-rooms and dungeons be but temporary. It is not long since I noticed in a Newspaper, published near the borders or this State, the following paragraph: ‘It is our fate,’ writes the Editor, ‘to be located opposite the County Jail, in which are now confined four miserable creatures bereft of the God-like attribute of reason: two of them females; and our feelings are daily excited by sounds of woe, that would harrow up the hardest soul. It is horrible that for the sake of a few thousand dollars the wailings of the wretched should be suffered to issue from the gloomy walls of our jails without pity and without relief.’”


Dorothea Lynde Dix, 1848


Some time after Dorothea’s address the Broughton Hospital for the Insane was created in North Carolina.